Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial

Ann Oncol. 2013 Nov;24(11):2808-13. doi: 10.1093/annonc/mdt360. Epub 2013 Sep 22.


Background: Two previous GINECO elderly specific studies in advanced ovarian cancer (AOC) patients highlighted the prognostic value of geriatric covariates for overall survival (OS).

Patients and methods: This open-label prospective trial was designed to identify the impact of geriatric covariates on OS in AOC patients ≥70 years treated with first-line carboplatin.

Results: Geriatric covariates of the 111 patients included median age 79 years (≥80 years: 41%); performance status (PS) ≥2: 47%; ≥3 major comorbidities: 24%; ≥4 comedications: 68%; activities of daily living (ADL) score <6: 55%; instrumental activities of daily living (IADL) score <25: 69%; Hospital Anxiety and Depression Scale (HADS) >14: 37%. The median OS was 17.4 months. Overall, 74% of patients completed the six planned chemotherapy cycles. Grade 3-4 haematological toxic effects were frequent (50%) but manageable. Grade 3-4 non-haematological toxicities included fatigue (15%), anorexia (12%), infections (9%) and thrombosis (2%). A survival score = exp(0.327*GVS) was developed, where the geriatric vulnerability score (GVS) is the sum of the following (each assigned a value of one): albuminaemia <35 g/l; ADL score <6; IADL score <25; lymphopaenia <1 G/l; and HADS >14. With a cut-off ≥3, GVS discriminated two groups with significantly different OS, treatment completion, severe adverse events and unplanned hospital admissions rates.

Conclusions: The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.

Keywords: elderly; geriatrics; ovarian cancer; prognostic factors.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carboplatin / administration & dosage*
  • Carboplatin / adverse effects
  • Comorbidity
  • Drug-Related Side Effects and Adverse Reactions / classification
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Female
  • Geriatric Assessment*
  • Humans
  • Neoplasm Staging
  • Ovarian Neoplasms / classification
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Prognosis*
  • Prospective Studies
  • Survival Analysis
  • Treatment Outcome


  • Carboplatin